Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience
Hemolytic-uremic syndrome (HUS) is a leading cause of childhood acute kidney injury (AKI) worldwide, with its postdiarrheal (D+HUS) form being the most common. Scarce data are available regarding D+HUS epidemiology from developing countries. This study aims to reveal the characterization of D+ HUS i...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Saudi Journal of Kidney Diseases and Transplantation |
| Online Access: | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2020;volume=31;issue=6;spage=1376;epage=1387;aulast=Eid |
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| author | Riham Eid Ashraf Bakr Atef Elmougy Mohamed M Zedan Nahla A Allam Amr Sarhan Ayman Hammad Ahmed M El-Refaey Nashwa Hamdy |
| author_facet | Riham Eid Ashraf Bakr Atef Elmougy Mohamed M Zedan Nahla A Allam Amr Sarhan Ayman Hammad Ahmed M El-Refaey Nashwa Hamdy |
| author_sort | Riham Eid |
| collection | DOAJ |
| description | Hemolytic-uremic syndrome (HUS) is a leading cause of childhood acute kidney injury (AKI) worldwide, with its postdiarrheal (D+HUS) form being the most common. Scarce data are available regarding D+HUS epidemiology from developing countries. This study aims to reveal the characterization of D+ HUS in Egyptian children. This is a retrospective study of all children with D+HUS admitted to a tertiary pediatric hospital in Egypt between 2007 and 2017. The study included epidemiological, clinical and laboratory data; management details; and outcomes. A cohort of 132 children aged 4months to 12 years was analyzed. Yearly incidence peaked in 2017, and spring showed the highest peak. All cases had a diarrheal prodrome that was bloody in 83% of the cases. Edema and decreased urine output were the most frequent presentations (50.3% and 42.4%, respectively). Escherichia coli was detected in 56 cases. Dialysis was performed in 102 cases. Eight patients died during acute illness, while five patients experienced long-term sequels. Lactate dehydrogenase (LDH) positively correlated with serum creatinine and negatively correlated with reticulocytic count. Univariate analysis showed that longer anuria duration, short duration between diarrheal illness and development of AKI (P = 0.001), leukocyte count above 20 × 109 cells/L (P ≤ 0.001), platelet count below 30 × 109 cells/L (P = 0.02), high LDH levels (P = 0.02) and hematocrit above 30% (P = 0.0001), need for dialysis (P = 0.03), and neurological involvement (P ≤ 0.001) were associated with unfavorable outcomes. This is the first report with a detailed insight into the epidemiology of D+HUS in Egyptian children. The incidence of D+HUS is increasing in our country due to increased awareness of the disease and the poor public health measures. Anuria duration, leukocyte count, and neurological involvement are predictors of poor outcome in the current work, and LDH is introduced as a marker of disease severity. |
| first_indexed | 2024-12-17T01:01:05Z |
| format | Article |
| id | doaj.art-e36e690c02d5460dbf66accefdb7cca0 |
| institution | Directory Open Access Journal |
| issn | 1319-2442 |
| language | English |
| last_indexed | 2024-12-17T01:01:05Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Kidney Diseases and Transplantation |
| spelling | doaj.art-e36e690c02d5460dbf66accefdb7cca02022-12-21T22:09:26ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422020-01-013161376138710.4103/1319-2442.308349Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experienceRiham EidAshraf BakrAtef ElmougyMohamed M ZedanNahla A AllamAmr SarhanAyman HammadAhmed M El-RefaeyNashwa HamdyHemolytic-uremic syndrome (HUS) is a leading cause of childhood acute kidney injury (AKI) worldwide, with its postdiarrheal (D+HUS) form being the most common. Scarce data are available regarding D+HUS epidemiology from developing countries. This study aims to reveal the characterization of D+ HUS in Egyptian children. This is a retrospective study of all children with D+HUS admitted to a tertiary pediatric hospital in Egypt between 2007 and 2017. The study included epidemiological, clinical and laboratory data; management details; and outcomes. A cohort of 132 children aged 4months to 12 years was analyzed. Yearly incidence peaked in 2017, and spring showed the highest peak. All cases had a diarrheal prodrome that was bloody in 83% of the cases. Edema and decreased urine output were the most frequent presentations (50.3% and 42.4%, respectively). Escherichia coli was detected in 56 cases. Dialysis was performed in 102 cases. Eight patients died during acute illness, while five patients experienced long-term sequels. Lactate dehydrogenase (LDH) positively correlated with serum creatinine and negatively correlated with reticulocytic count. Univariate analysis showed that longer anuria duration, short duration between diarrheal illness and development of AKI (P = 0.001), leukocyte count above 20 × 109 cells/L (P ≤ 0.001), platelet count below 30 × 109 cells/L (P = 0.02), high LDH levels (P = 0.02) and hematocrit above 30% (P = 0.0001), need for dialysis (P = 0.03), and neurological involvement (P ≤ 0.001) were associated with unfavorable outcomes. This is the first report with a detailed insight into the epidemiology of D+HUS in Egyptian children. The incidence of D+HUS is increasing in our country due to increased awareness of the disease and the poor public health measures. Anuria duration, leukocyte count, and neurological involvement are predictors of poor outcome in the current work, and LDH is introduced as a marker of disease severity.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2020;volume=31;issue=6;spage=1376;epage=1387;aulast=Eid |
| spellingShingle | Riham Eid Ashraf Bakr Atef Elmougy Mohamed M Zedan Nahla A Allam Amr Sarhan Ayman Hammad Ahmed M El-Refaey Nashwa Hamdy Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience Saudi Journal of Kidney Diseases and Transplantation |
| title | Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience |
| title_full | Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience |
| title_fullStr | Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience |
| title_full_unstemmed | Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience |
| title_short | Postdiarrheal hemolytic uremic syndrome in Egyptian children: An 11-year single-center experience |
| title_sort | postdiarrheal hemolytic uremic syndrome in egyptian children an 11 year single center experience |
| url | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2020;volume=31;issue=6;spage=1376;epage=1387;aulast=Eid |
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